Europe remains at risk of a devastating stroke crisis, according to a major new report published yesterday, World Stroke Day.

Only 16 per cent of the public worldwide are aware that the risk of AF-related stroke can be reduced with anticoagulant treatment

Entitled How Can We Avoid a Stroke Crisis in Europe?, the report, published by Action for Stroke Prevention (ASP), a UK alliance of renowned health experts and patient organisations, calls for policymakers and the medical and patient communities to join forces and act to prevent strokes that strike thousands of people with atrial fibrillation (AF) each year.

Affecting 10 million people in Europe alone, AF is an under-diagnosed, undertreated abnormal heart rhythm which increases stroke risk fivefold.

Crucially, AF-related strokes are more serious than those resulting from other causes. This means that people who do suffer an AF-related stroke are less likely to be able to return to their own homes and will need more care from their families or nursing homes.

Despite the overwhelming fear of stroke and its devastating consequences, a new Ipsos Mori survey shows that 52 per cent of Europeans are unaware of AF, highlighting a critical educational challenge for policymakers and healthcare providers.

The report highlights that the first time many people will find out they have AF is when they have a stroke. Furthermore, approximately 70 per cent of patients with known AF who had a stroke caused by a blood clot were not receiving anticoagulant therapy to prevent AF-related stroke at the time.

With stretched healthcare budgets and the annual cost of stroke in Europe at approximately €64 billion, more needs to be done to reduce the number of these serious, costly and yet preventable strokes.

In addition to their report, ASP has launched two supplementary reports for healthcare decision makers and healthcare professionals respectively, that provide concrete action steps that can be taken at a community level to reduce the personal and economic impact of AF-related stroke.

“We need to ensure that AF is recognised as a serious risk factor for stroke in national prevention plans and that concrete actions are defined in these plans that support earlier diagnosis and improved awareness, education and prevention,” said world-renowned cardiology expert, John Camm, professor of clinical cardiology at St George’s University, London, UK.

“It is our hope that national governments will address this as they plan how to meet the UN’s commitment to reduce non-communicable diseases by 25 per cent by the year 2025.”

The critical challenge is for key parties – healthcare professionals, policymakers, medical societies, patient advocacy groups and industry alike – to work together to reduce the burden of AF-related stroke.

Recommendations made by the report and supporting supplementary reports include:

◆ Improving public awareness and understanding of AF and the risk of AF-related stroke;

◆ Implementing effective practice standards and targets for healthcare professionals; for example, targets for AF screening;

◆ Facilitating the exchange of best practice between member states;

◆ Developing strategies to support adherence to clinical guidelines and the provision of equal and adequate administration of therapy for people with AF.

Cecilia Wikström, member of the European Parliament (MEP) and a co-author of the report’s foreword commented: “I support the recommendations made by Action for Stroke Prevention and believe it is important they are addressed in stroke, cardiovascular and non-communicable disease strategies.

52 per cent of Europeans are unaware of AF, highlighting a critical educational challenge for policymakers and healthcare providers

“Their implementation will contribute to the prevention of stroke in people with AF and, in turn, reduce the dramatically increasing clinical, economic and social burden of stroke in Europe. It is important that governments and healthcare policymakers take action to ensure that diagnosis and appropriate treatment are available to all European citizens.”

A new Ipsos Mori survey of 9,211 people from 20 countries across the globe has underlined the urgent need to act on Action for Stroke Prevention’s recommendations.

Findings in Europe highlight that while nearly a third (31 per cent) of people fear having a stroke above some other serious health conditions including heart disease, diabetes and high cholesterol, 52 per cent of people in Europe have not heard of AF.

Worryingly, the survey also revealed that 85 per cent of people in Europe are unaware that AF is a serious risk factor for stroke.

While 65 per cent of Europeans identified high blood pressure as a stroke risk factor, only 15 per cent know that AF is a risk factor for stroke, despite AF increasing the risk of stroke more than high blood pressure.

Despite the availability of clinical practice guidelines, such as the European Society of Cardiology Guidelines on AF, adherence to them is poor and there remains a chronic underuse of effective stroke prevention therapies in AF, with several studies reporting anticoagulant use in less than 50 per cent of people with AF who are at high risk of stroke.

The survey showed that, perhaps unsurprisingly, only 16 per cent of the public worldwide are aware that the risk of AF-related stroke can be reduced with anticoagulant treatment, demonstrating the need for education to enable patients to participate in their own healthcare decisions.

Ipsos Mori interviewed 9,211 adults aged 40+ across 20 countries.

The European sample of the survey consisted of UK, Germany, Spain, Italy, France, Portugal, Ireland, Russia, Bulgaria, Poland and Hungary.

Interviews in all markets except Bulgaria were conducted by telephone between September 3 and 17.

A major public health issue

The World Stroke Campaign aims to disseminate essential life-saving information and share knowledge about actions and lifestyle behaviours that could avert the assault of stroke.

The campaign will also identify opportunities to improve and educate the public on the fundamental need for appropriate and quality long-term care and support for stroke survivors, including the empowerment of stroke care-providers.

Here are a few facts:

◆ Stroke is a major public health issue. It is the second biggest cause of cardiovascular death, after ischaemic heart disease, killing an estimated 1.3 million people in Europe every year (14 per cent of all deaths) and 6.2 million people worldwide.

◆ It is a condition which on its own represents the third single most common cause of death in industrialised countries.

◆ Stroke can be prevented.

◆ Stroke can be treated.

◆ Stroke can be managed in the long-term.

◆ One in six people will have a stroke in their lifetime.

◆ Every six seconds stroke kills someone.

◆ Every other second stroke attacks a person, regardless of age or gender.

◆ 15 million people experience a stroke each year, six million of them do not survive.

◆ About 30 million people have had a stroke – most have residual disabilities.

◆ Atrial fibrillation (AF) is the most common sustained heart rhythm abnormality and is a strong independent risk factor for stroke.

◆ Patients with AF are five times more likely to have a stroke compared with the rest of the population.

◆ AF occurs when the upper chambers of the heart (the atria) tremble rapidly and irregularly. This leads to blood stasis or pooling within the atria, which can result in the development of blood clots. These clots can subsequently break away from the atria and travel to vessels in the brain causing a stroke.

◆ In Europe an estimated 10 million people have AF and AF-related stroke is a growing health epidemic due to Europe’s ageing population, and as survival after conditions that predispose to AF (such as heart attack) improves.

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